Tanawin Nopsopon1, Jathurong Kittrakulrat2, Kullaya Takkavatakarn3, Thanee Eiamsitrakoon4, Talerngsak Kanjanabuch3, Krit Pongpirul1,5,6. 1. Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 2. Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 3. Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 4. Division of Nephrology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand. 5. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America. 6. Bumrungrad International Hospital, Bangkok, Thailand.
Abstract
BACKGROUND: The novel coronavirus (COVID-19), caused by SARS-CoV-2, showed various prevalence and case-fatality rates (CFR) among patients with different pre-existing chronic conditions. End-stage renal disease (ESRD) patients with renal replacement therapy (RRT) might have a higher prevalence and CFR due to reduced immune function from uremia and kidney tropism of SARS-CoV-2, but there was a lack of systematic study on the infection and mortality of the SARS-CoV-2 infection in ESRD patients with various RRT. METHODOLOGY/PRINCIPAL FINDINGS: We searched five electronic databases and performed a systematic review and meta-analysis up to June 30, 2020, to evaluate the prevalence and case fatality rate (CFR) of the COVID-19 infection among ESRD patients with RRT. The global COVID-19 data were retrieved from the international database on June 30, 2020, for estimating the prevalence and CFR of the general population as referencing points. Of 3,272 potential studies, 34 were eligible studies consisted of 1,944 COVID-19 confirmed cases in 21,873 ESRD patients with RRT from 12 countries in four WHO regions. The overall pooled prevalence in ESRD patients with RRT was 3.10% [95% confidence interval (CI) 1.25-5.72] which was higher than referencing 0.14% global average prevalence. The overall estimated CFR of COVID-19 in ESRD patients with RRT was 18.06% (95% CI 14.09-22.32) which was higher than the global average at 4.98%. CONCLUSIONS: This meta-analysis suggested high COVID-19 prevalence and CFR in ESRD patients with RRT. ESRD patients with RRT should have their specific protocol of COVID-19 prevention and treatment to mitigate excess cases and deaths.
BACKGROUND: The novel coronavirus (COVID-19), caused by SARS-CoV-2, showed various prevalence and case-fatality rates (CFR) among patients with different pre-existing chronic conditions. End-stage renal disease (ESRD) patients with renal replacement therapy (RRT) might have a higher prevalence and CFR due to reduced immune function from uremia and kidney tropism of SARS-CoV-2, but there was a lack of systematic study on the infection and mortality of the SARS-CoV-2 infection in ESRDpatients with various RRT. METHODOLOGY/PRINCIPAL FINDINGS: We searched five electronic databases and performed a systematic review and meta-analysis up to June 30, 2020, to evaluate the prevalence and case fatality rate (CFR) of the COVID-19infection among ESRDpatients with RRT. The global COVID-19 data were retrieved from the international database on June 30, 2020, for estimating the prevalence and CFR of the general population as referencing points. Of 3,272 potential studies, 34 were eligible studies consisted of 1,944 COVID-19 confirmed cases in 21,873 ESRDpatients with RRT from 12 countries in four WHO regions. The overall pooled prevalence in ESRDpatients with RRT was 3.10% [95% confidence interval (CI) 1.25-5.72] which was higher than referencing 0.14% global average prevalence. The overall estimated CFR of COVID-19 in ESRDpatients with RRT was 18.06% (95% CI 14.09-22.32) which was higher than the global average at 4.98%. CONCLUSIONS: This meta-analysis suggested high COVID-19 prevalence and CFR in ESRDpatients with RRT. ESRDpatients with RRT should have their specific protocol of COVID-19 prevention and treatment to mitigate excess cases and deaths.
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